Subarachnoid hemorrhage in pregnancy

✓ A series of women who had spontaneous subarachnoid hemorrhage during pregnancy is reviewed. These patients are more likely than the average to have an angiographically demonstrable lesion, with arteriovenous anomalies and aneurysms occurring equally. The clinical features are evaluated so that an idea of the causative lesion can be gained at the bedside in the absence of specific neurological tests. When the known cardiovascular changes of pregnancy are correlated with the clinical features in these patients, it is found that subarachnoid hemorrhage from an arteriovenous anomaly or aneurysm in pregnancy is not related to the increased cardiac output. From these data, the preferred neurosurgical and obstetrical management is defined.